Characteristics of uterine activity in gestations less than 20 weeks

Article Abstract:

A new home monitoring system measures uterine activity in pregnant women with a great deal of accuracy. Programs aimed at reducing the incidence of preterm birth, delivery of a fetus before the 37th completed week of pregnancy, utilize a home monitoring system in conjunction with daily contact with perinatal nurses. Uterine activity is recorded periodically throughout the day and transmitted over the telephone to be interpreted by the perinatal nurses. This preterm prevention program is able to diagnose preterm labor before it is too late to institute effective management strategies. Most studies have focused on the degree and intensity of uterine activity during the latter part of pregnancy (greater than 24 weeks of pregnancy). There is little information regarding the outcome of pregnancies having increased uterine activity before the 20th week of pregnancy. The uterine activity was measured by a home monitoring device (ambulatory tocodynamometer) in 37 patients at risk for preterm delivery, who were between the 14th and 19th week of pregnancy. Preterm labor was detected in seven patients, six of whom experienced an increase in uterine activity prior to the diagnosis and three of whom had physical signs and symptoms of labor. The pattern of uterine contractions was different in women who later developed preterm labor than in those continuing pregnancy and laboring at term (term pregnancy is 40 weeks). Women who developed preterm labor had an increase in uterine activity during the 18th and 19th weeks of pregnancy. Therefore, there is a relationship between the pattern of uterine activity in the early weeks of pregnancy and true preterm labor. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Uterus, Uterine contractions

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Cost/health effectiveness of home uterine activity monitoring in a Medicaid population

Article Abstract:

The high cost of caring for a surviving premature infant in neonatal intensive care units is thought to exceed $5 billion a year. A new home monitoring system, which measures patterns of uterine contractions in pregnant women at risk for early delivery, is more accurate in detecting preterm labor than patient reports of signs and symptoms alone. Programs aimed at reducing the incidence of preterm birth utilize the home monitoring system in conjunction with daily contact with perinatal nurses. Uterine activity is recorded periodically throughout the day and transmitted via the telephone, to be interpreted by the perinatal nurses. In patients at risk for preterm delivery, this type of prevention program is able to diagnose preterm labor early, which allows effective management strategies to be initiated before delivery is unavoidable. The cost-effectiveness of the home monitoring device was established for a group of women receiving Medicaid public assistance. Preterm labor occurred in 49 percent of the 130 women at risk for preterm labor. The diagnosis relying on the monitoring system permitted pregnancies to be prolonged for an average of 4.9 weeks. Fewer than 10 percent of the patients delivered because they failed to respond to tocolytic agents (which arrest labor) or because the cervix dilated. It was estimated that the home monitoring device saved over $3 million ($23,573 per patient) in newborn intensive care costs and monitoring expenses. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Evaluation, Finance, Medical care, Cost of, Health care costs, Patient monitoring, Physiologic monitoring

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• Abstracts: The contribution of symptomatology and/or uterine activity to the incidence of unscheduled visits. part 2
• Abstracts: Uterine activity and symptoms as predictors of preterm labor

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